Audit: Maine didn't adequately protect disabled residents

AUGUSTA, Maine — Maine has failed to adequately report and investigate deaths and abuse of its residents with developmental disabilities, according to a federal audit released Thursday.

The report released by the Office of Inspector General for the U.S. Department of Health and Human Services says the Maine Department of Health and Human Services failed 2,640 Medicaid beneficiaries who are allowed under a federal waiver to use community- and home-based services rather than state-run institutions.

The federal review comes amid concern in Congress over abuse and deaths in group homes serving those with developmental disabilities. Previous audits highlighted similar concerns in Massachusetts and Connecticut, and David Lamir, regional inspector general for the Office of Inspector General, said reviews in other states are underway.

The audit includes examples of uninvestigated incidents like a person who fell out of bed and later suffered a fractured right clavicle and another person who ingested laundry soup while helping a staff member clean up urine. In one instance, a person fell in the bathtub while unattended and drowned.

"The beneficiary's death was not investigated by the state agency as an untimely death," meaning there was no review completed on what could have prevented it, according to the report.

Auditor John Sullivan, who worked on Maine's audit, said they interviewed people with developmental disabilities in Maine who raised concern about the low pay of unlicensed staff at community-based, institutionalized settings.

"That was one of their major concerns," Sullivan said. "The wages they're paying the employees is comparable to McDonald's. The employers would rather work in McDonald's settings because it wasn't as stressful."

In a statement, Ricker Hamilton, the Maine agency's acting head, said the report "does not present an accurate picture of the system of protection for individuals with intellectual disabilities and autism today." He said the report raises issues that existed during a period of "significant transition," when offices were being consolidated, and have since been addressed.

"In no way should this report tarnish the dedication of so many individuals who work across the state to provide critical services to those who need them," said Hamilton, who took over the job this year after the departure of former commissioner Mary Mayhew, a Republican candidate for governor.

The agency disagreed with the report's findings that it failed to ensure community-based providers reported all dangerous situations and that it failed to investigate or report important incidents to authorities. But the agency agreed with recommendations aimed at working with community-based providers and analyzing data to prevent repeat deficiencies.

The report says that from January 2013 through June 2015, the agency did not investigate any of the 133 deaths involving people with developmental disabilities. The report says the agency confirmed that investigations had not been opened by law enforcement for those deaths.

Agency officials said a mortality review committee looked at 54 of the deaths, but the report says the state didn't provide details about those reviews or follow-up action taken.

According to the audit, providers said agency officials told them over several months ending in early 2013 to stop performing administrative reviews of dangerous risks involving people with developmental disabilities. The report says the state wasn't able to explain why the reviews weren't submitted or why it didn't know that providers hadn't submitted reports for 8,678 critical events involving this population. Those included serious injuries and suicidal acts involving 1,781 people.

Hamilton said the state didn't instruct providers to stop performing the reviews. He said providers were required to review some of the incidents, while adult protective services handled cases involving abuse, neglect or exploitation.

Never miss a story

Choose the plan that's right for you.
Digital access or digital and print delivery.